United States: Elevated occurrences of adverse childhood experiences (ACEs) are markedly linked to heightened susceptibility to depressive, anxious, and stress-induced disorders in adulthood, as per recent findings derived from an extensive registry study involving twins.
Investigative analysis revealed that each additional adverse event augmented the risk of developing psychiatric disozrders in adulthood by 52 percent, with sexual abuse exhibiting the most substantial correlation.
The observations persisted even after accounting for shared genetic and environmental elements.
The outcomes imply that “measures aimed at mitigating ACEs, encompassing primary prevention and bolstered accessibility to evidence-based trauma interventions for individuals who have undergone ACEs, could potentially mitigate the risk of future psychopathological occurrences,” noted the researchers, led by primary author Hilda Björk Daníelsdóttir, MSc, affiliated with the University of Iceland, Reykjavik, Iceland.
These findings were disseminated online on March 6 in JAMA Psychiatry.
Graduated Influence
Prior investigations have consistently demonstrated a robust correlation between childhood maltreatment and heightened susceptibility to psychiatric disorders in adulthood. However, evidence substantiating this link in studies adjusting for familial confounders is notably scarce, as stated by the researchers.
In order to glean further insights into how genetic components might influence the nexus between ACEs and subsequent psychiatric diagnoses, the researchers leveraged data sourced from the nationwide Swedish Twin Registry, encompassing information pertaining to over 25,000 identical and fraternal twins.
This registry is cross-referenced with the Swedish National Patient Registry, which documents inpatient or outpatient psychiatric diagnoses post the age of 19.
Respondents, who were twins, completed an extensive web-based questionnaire evaluating depressive symptoms experienced in the past week as an indicator of current mental well-being, in addition to detailing various types of ACEs, including familial violence, emotional neglect, or abuse, physical neglect or abuse, sexual abuse, rape, and hate crimes.
Three cohorts of twins from the registry were surveyed between 2005 and 2016 and were subsequently monitored via the national registry from the age of 19 until the culmination of 2016.
Among the sample comprising 25,000 twin pairs (15,000 female, with a mean age at assessment of 29 years), 39 percent (9750 participants) reported exposure to at least one ACE, while 8 percent (2000 participants) reported exposure to three or more ACEs. The majority of respondents, constituting 61 percent, reported no ACE exposure.
In excess of 2300 participants received a psychiatric diagnosis in adulthood. The incidence of any psychiatric disorder escalated from 6.4 percent (503 individuals) among participants devoid of any ACEs to 24.6 percent (993 individuals) among those reporting three or more ACEs.
At the cohort level, a higher incidence of ACEs was correlated with augmented odds of any psychiatric disorder in a dose-dependent manner, as observed by the researchers (odds ratio [OR], 1.52; 95 percent CI, 1.48-1.57).
Disentangling Genetic and Environmental Factors
In order to acknowledge that each factor of this greater risk of adult mental illnesses is caused by ACE or genetic factor or environment, the researchers designed the study in the way that there was one twin in each pair among siblings who had experienced a particular ACE while other siblings didn’t. The two variables were found to have a nonlinear correlation among them, which was only slightly low. The risk of psychiatric illness likelihood in the case of identified twins is 20 percent higher amongst which (1.20; 95 percent CI, 1.02-1.40) while non-identical twins, 29 percent surged (1.29; 95 percent CI, 1.14-1.47) when the environmental factor (ACE)
Lastly, the weakened causal link implies that ACEs are a rice factor, which may have also confounded the relationship between familial issues and adult mental health disorders.
Out of all the ACEs, sex abuse poses the highest threat to developing adult mental health problems. Individuals exposed to sexual abuse exhibited up to a 200 percent greater risk of any psychiatric disorder in the following comparisons: A cohort contains many pairs (OR, 3.09; 95 percent CI, 2.68-3.56), dizygotic (OR, 2.10; 95 percent CI, 1.33-3.33) (1.80; 95 percent CI, 1.04-3.11).
“Hence, the study found that while the association between sexual abuse and adult psychiatric disorders could be that it is these that are actually chimed, it was found that family conditions influenced greater likelihood but not to the level of the impact of the two,” affirmed the authors.
The conventional retrospective approach to ACE disclosure, as one critical bias in the study, has the capacity to fabricate the memories of the participants. This can lead to results and conclusions that may not be applicable to other cultures and societies.
The funding of this research was a joint arrangement between the European Research Council, the Icelandic Center for Research and the European Union Horizon 2020.